Provider Demographics
NPI:1700053329
Name:KERN COUNTY AGING AND ADULT SERVICES DEPT
Entity Type:Organization
Organization Name:KERN COUNTY AGING AND ADULT SERVICES DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRASTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-868-1053
Mailing Address - Street 1:5357 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0641
Mailing Address - Country:US
Mailing Address - Phone:661-868-1000
Mailing Address - Fax:661-868-1001
Practice Address - Street 1:5357 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0641
Practice Address - Country:US
Practice Address - Phone:661-868-1000
Practice Address - Fax:661-868-1001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF KERN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMSS00029F251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSS00029FMedicaid